急性颅脑伤后抗氧化能力变化的临床研究

Clinical Study of Anti oxidizing Power Changes in Body After Acute Craniocerebral Trauma

目的研究氧自由基在继发性脑损伤中的病理生理作用及其临床意义。方法用比色法动态检测１５６例急性颅脑外伤病人血液中丙二醛（ＭＤＡ）、超氧化物岐化酶（ＳＯＤ）、谷胱甘肽（ＧＳＨ）、谷胱甘肽过氧化物酶（ＧＳＨ－ＰＸ），ＶｉｔＥ及总抗氧化能力（ＴＡＯＰ）的变化，与２３５例正常平均值对照。结果（１）伤后２４小时内血清ＭＤＡ、ＳＯＤ、ＴＡＯＰ升高，ＧＳＨ、ＧＳＨ－ＰＸ、ＶｉｔＥ下降；（２）受伤２４，４８，７２小时后ＭＤＡ呈持续升高趋势，其他指标则逐渐下降。这种变化均以７２小时后最为明显；（３）重型、特重型颅脑外伤ＭＤＡ升高及ＴＡＯＰ下降尤为显著且超早期发生。结论提示原发脑损伤愈重，氧自由基继发性损害作用愈强，预后愈差。

Aim To study the pathophysiological implication of the anti oxidizing power changes after craniocerebral trauma. Methods We examined actively the content of malonaldehyde (MDA), suproxide dismutase (SOD), glutathione (GSH), glutathione peroxide (GSH PX), Vitamin E (V E) and the total anti oxidizing power (TAOP) levels in the patient's blood (158 cases). Results (1) Within 24 hours after injury, the MDA, TAOP and SOD levels increased but GSH, GSH PX and V E levels decreased. (2) We examined the above indexes at 24, 48 and 72 hours after injury and found that MDA increased gradually, but the others decreased slowly. They changed markedly at 72 hours after injury. (3) The increasing of MDA and decreasing of TAOP changed markedly especially at an earlier stage of the severe and extra severe patients. Conclusion It suggests that the more severe the primary injury of the brain is, the greater the secondary damage of the free radicle is and the worse the prognosis is. Early application of the free radicle of the cleaner agent can improve prognosis.